Respiratory failure in rapidly progressing pulmonary lymphoma. Role of immunophenotyping in diagnosis.
An asymptomatic man was found to have bilateral small pulmonary infiltrates on a preoperative chest roentgenogram. Over a 4-wk period there was rapid progression of the infiltrates with a clinical picture suggestive of adult respiratory distress syndrome. Open lung biopsy showed a high grade lymphoma filling and distorting the pulmonary parenchyma. Flow cytometry of pleural fluid showed an aberrant phenotype consistent with T cell lymphoma. The patient died of progressive respiratory failure 6 wk after the first radiographic abnormalities were detected. With further experience, immunophenotyping of pleural fluid may secure definitive diagnoses in certain clinical situations, obviating more invasive procedures.
Eliasson
A H
AH
Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001.
Rajagopal
K R
KR
Dow
N S
NS
D000943:Antigens, Differentiation / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D008223:Lymphoma / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D010996:Pleural Effusion / Q000473:pathology; D012131:Respiratory Insufficiency / Q000209:etiology*; D013601:T-Lymphocytes / Q000276:immunology
D000943:Antigens, Differentiation; D014408:Biomarkers, Tumor